Glucosamine

Important information about Glucosamine
Glucosamine is made from the combination of a sugar - hence the first part of the name glucos(e) - and an amine, which is a derivative of ammonia containing nitrogen (N) and hydrogen (H) atoms. Glucosamine is found largely in cartilage and plays an important role in its health and resiliency. As we age, we lose some of the glucosamine and other substances in cartilage. This can lead to thinning of cartilage and the onset and progression of osteoarthritis. It is important to note that there are a variety of important substances within cartilage and glucosamine ingestion, by itself, should not be viewed as the complete answer. In fact, not all studies show glucosamine to be helpful by itself. Glucosamine is more likely to be effective when taken with other nutrients such as MSM and chondroitin.

Glucoamine and Osteoarthritis
Glucosamine has hardly been evaluated in conditions other than osteoarthritis. Hence it is not clear whether glucosamine is helpful in those with damage to cartilage or joints due to musculoskeletal injuries. Glucosamine appears to help rebuild cartilage in osteoarthritis patients, but it is unlikely that it would help joints where the cartilage has been surgically removed. Similarly, gucosamine has not been tested in autoimmune diseases involving joints such as lupus and rheumatoid arthritis. Those with artificial joints are not likely to be helped by glucosamine since they have no cartilage.

Combining Glucosamine with Drugs
Glucosamine may be taken together with acetaminophen or NSAIDs such as ibuprofen and naproxen. After glucosamine starts working in a few weeks, hopefully the dose of the drugs can be reduced or eliminated. I am not aware of glucosamine interacting with other medicines.

Glucosamine sulfate of hydrochloride
Glucosamine is available as glucosamine sulfate or glucosamine hydrochloride. A review of the scientific literature shows glucosamine is likely to be helpful for many patients with osteoarthritis. Almost all of the studies done with glucosamine have used the sulfate form since a company in Europe funded the studies, and we know that it works. However, the hydrochloride form has been used by doctors for many years and it seems to work just as well. The hydrochloride form is cheaper. The positive effects of glucosamine reducing joint pain are often noticed within a few weeks.

Glucosamine and allergies
Those who are allergic to sulfates may take glucosamine hydrochloride and not glucosamine sulfate, and they should avoid chondroitin sulfate. Glucosamine is derived from shrimp, oyster and crab shells and chondroitin is derived from cartilage of cows, pigs, and sharks. There is no synthetically made glucosamine on the market.

Long term safety
Based on our current understanding, glucosamine can be taken for extended periods, months and years. Thus far, after being on the market for quite a number of years, there have not been any reports in the medical literature of any significant side effects resulting from the use of glucosamine. However, as with most nutrients and medicines, long term effects are not clearly known. It is best pregnant women not take glucosamine until more is known about this interaction.

Timing of Glucosamine ingestion
It's difficult to say when the best time or frequency to take glucosamine, whether with or without food, but a good option is to take glucosamine before meals. All 1,500 mg a day can be taken at one time or split in two or three divided doses throughout the day.

Glucosamine and Chondroitin
If glucosamine itself is not helpful in relieving arthritic symptoms, it may be combined with chondroitin and other nutrients. Alternatively, glucosamine and chondroitin can be started together with several other nutrients.